Hydronephrosis and pelvic organ prolapse.
OBJECTIVE
To determine the prevalence of hydronephrosis in a cohort of women who had undergone surgery for pelvic organ prolapse (POP).


METHODS
This observational, retrospective survey was conducted from January 2000 to December 2007 on 257 consecutive candidates for vaginal or abdominal surgical repair of POP (grade >2). In all patients, a standard clinical and instrumental urogynecologic workup was followed by POP repair. Follow-up visits were scheduled at 3, 6, and 9 months postoperatively and then annually.


RESULTS
Preoperative hydronephrosis was found in 13 patients (5%) with a mean age of 69.2 +/- 6.6 years. It was moderate in 5 and severe in 8; bilateral in 8 (3.1%), monolateral in 5 (1.9%); and POP-related in 9 cases. Surgical POP repair resolved the prolapse all patients and cured the ureterohydronephrosis in 7, with moderate ectasia of the upper urinary tract persisting in 2. The renal function at diagnosis was normal in 12 of 13 patients with hydronephrosis (mean 113 +/- 15 micromol/L); 1 patient had a high serum creatinine concentration (220 micromol/L). No patient developed renal failure during a mean follow-up of 43.5 months.


CONCLUSIONS
The prevalence of hydronephrosis was low in patients with POP who were candidates for surgery. POP repair usually resolves prolapse-related hydronephrosis and prevents serious long-term complications.
Costantini
Elisabetta
E
Section of Urology and Andrology, Department of Medical-Surgical Specialties and Public Health, University of Perugia, Perugia, Italy. ecostant@unipg.it
Lazzeri
Massimo
M
Mearini
Luigi
L
Zucchi
Alessandro
A
Del Zingaro
Michele
M
Porena
Massimo
M
D000368:Aged; D052858:Cystocele / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000453:epidemiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*